Ms Renee Cooper1, Ms Sandra Sullivan1
1South Western Sydney Local Health District, Australia
Biography:
Sandra Sullivan BRN, MPH (UNSW)
Sandra is a Clinical Nurse Consultant in South Western Sydney Local Health District with 20 years’ experience working in community palliative care. Sandra is a current committee member of Palliative Care NSW.
Sandra is committed to improving the experience of clients and their corers receiving palliative care at home.
Renee Cooper
Renee is a Clinical Nurse Consultant in South Western Sydney Local Health District, with 18 years of experience working in community palliative care across metropolitan and rural NSW.
Renee is a passionate advocate for access to quality palliative care for all communities.
Abstract:
Background:
The Palliative Care Telephone Triage Guideline is used for triaging of palliative care clients into community nursing services. Our service works under a nurse led model, with small specialist teams supporting generalist community nurse in the provision of palliative care Our teams service a large multicultural community that experience significant socioeconomic disadvantage
Aim:
To audit triage practices across teams to assess consistency, quality, and compliance with the Palliative Care Telephone Triage Guideline.
Methods:
Using an improvement science approach, baseline audits were conducted at two points: (1) Community Nurses attending triage and (2) Palliative Care Nurses attending triage. Follow-up audits occurred two weeks after each change idea was implemented. A cause-and-effect diagram helped identify key issues, while a driver diagram tracked primary and secondary drivers and informed Plan-Do-Study-Act (PDSA) cycles.
Results:
Audits revealed inconsistent application of the guideline, poor documentation of Palliative Care Outcomes Collaboration (PCOC) phase and symptom severity, and difficulty determining appropriate timeframes from triage to first visit. Where timeframes could be assessed, few met targets. Triage was often documented in the wrong location and frequently exceeded the 20-minute allocation.
Conclusion:
Clinical audits effectively highlighted inconsistencies in triage practices. This led to guideline revisions and the creation of a documentation template, without increasing triage duration. It was determined that triage should be a shared responsibility between Community Health Nurses and Palliative Care Registered Nurses. Furthermore, triage was recognised as a skill requiring structured education and support. Consistent training across teams is essential to ensure uniformity and quality in practice.